MRCP Questions

MRCP Questions


Recently came across a few popular MRCP Part 2 questions. You may want to give these questions a try before looking at the answers at the end of this post.

1) A 58-year-old man with diabetes finds that the vision in one eye is blurred when he reads, but not at other times. The most likely diagnosis is:

A : Macular oedema
B : Floaters
C :Cataract
D :Glaucoma
E :Stroke.

2) A 22-year-old woman notice that her right eye vision has become blurred over the last three days and she can now see very little with it. The fundus (see image) shows:



A : papilloedema.
B : grade IV hypertensive retinopathy.
C : normal appearance.
D : optic disc swelling probably due to an acute optic neuropathy.
E : central retinal artery occlusion.

3) What does this optic fundus show?



A : Proliferative diabetic retinopathy
B : Background diabetic retinopathy
C : Grade III hypertensive retinopathy
D : Branch retinal vein occlusion
E : Central retinal vein occlusion


Answers:

1) A 2)D 3) B

New Drugs in MRCP- Rituximab

New Drugs in MRCP- Rituximab

I am going to talk about another –ximab drug today-Rituximab. If you are currently working in a haematology unit, Rituximab is not a stranger to you because I think haematologists are the ones who use this drug most.

As Infliximab, Rituximab ( Trade name: Rituxan) is also a chimeric monoclonal antibody , it was first approved in 1997 for the treatment of lymphoma and it has become a standard treatment for aggressive lymphoma. As you might remember during your medical time that CHOP is the standard treatment for lymphoma but currently the treatment of choice it is R-CHOP! (CHOP stands for Cytoxan, Hydroxyrubicin (Adriamycin), Oncovin (Vincristine), Prednisone/Prednisolone.)

Besides lymphoma, remember that Rituximab is also useful for the treatment of Rheumatoid arthritis, autoimmune haemolysis, idiopathic thrombocytopaenia purpura, Evans syndrome and SLE ( Systemic Lupus Erythematosis). Rituximab is a unique therapy that works selectively by depleting CD20+ B cells.

The side effects of Rituximab is quite similar to Infliximab.

Check out more about this drug HERE!

New Drugs in MRCP-Infliximab

Infliximab in MRCP

I learned pharmacology about 10 years ago. If you are one of few doctors that studied pharmacology many years ago, you might find some drugs that being asked in MRCP that you never come across before. I will talk about a few new drugs that are rather common and popular in MRCP that you might have not studied during your medical school.

The first drug is Infliximab ( Trade Name: Remicade) Infliximab is known as ‘ chimeric monoclonal antibody’ that blocks tumour necrosis factor alfa ( TNF alfa). You might come across the word ‘chimera’ in movies such as ‘Relic’ which means monster.



In Greek mythology, the Chimera is a monster, depicted as an animal with the head of a lion, the body of a she-goat, and the tail of a dragon (sometimes it has multiple heads).

In medicine, a chimera is an animal that has two or more different populations of genetically distinct cells that originated in different zygotes.

The first thing you need to know about Infliximab is its indications. Infliximab has been approved by the U.S. Food and Drug Administration for the treatment of psoriasis, pediatric Crohn's disease, ankylosing spondylitis, Crohn's disease, psoriatic arthritis, rheumatoid arthritis, and ulcerative colitis.

You must know that infiximab is classified as immunosuppressive drug, therefore always watch out for infections ( such as tuberculosis- always asked in MRCP. Always screen for possible latent TB before starting the drug!), blood disorders ( bone marrow suppression), cancers ( such as lymphoma) and allergic reaction.

Be careful if you want to start Infliximab in patients with heart failure and chronic viral hepatitis due to possibility of reactivation!